Exercise, Nutrition, WLS, and Cooking Q & A - 3/25/2014

I don't have all the answers but I have a few so if you have questions about Exercise, Nutrition, WLS, or Cooking this is the place to ask!

Let's Hear It!

Hi Keith. Here is a question for ya. I started walking several weeks ago. I'm not sure exactly what my distance is but I add a little every day. I walk outside on an asphalt road at for 40-45 minutes. I do run a tiny but here and there to try and keep my intensity up. So I noticed my knee was a little sore on Saturday but went ahead and walked Sunday and Monday. By Monday I knew I had maybe done something stupid because my knee was feeling stiff and very sore. When I looked at both knees together the sore one was a tiny bit swollen. So I have been putting ice on it and elevating it for 24 hours and it's feeling much better. So 2 questions. How long would you stay off of it, and do you think this requires a trip to the dr? I'm leaning toward thinking a physical therapist would be better to see if my gait is off, but what do I know. Thanks for any advice! Kathy

Being overweight is very hard on knees and ankles. My knees pretty much always hurt and I just sort of power through it. In my case it's the beginning stage of arthritis and I have some patella tracking issues. I basically massage them and stretch. You should at least get them xrayed to see what the issue is. 2 to 4 days off from your knees should be good. A good pair of running shoes is a must. 

Ok, so I am a bit confused!  I have been walk/jogging quite a bit lately.  Varying anywhere from 5-8 miles a day so far.  I dealt with a pretty harsh head and chest cold so I took a few days off from walking to be able to breath better.  I lost weight on my off days and I "maintain" on my exercise days.  My body seems to be in a long lasting plateau.  I am not where I want to be yet, so I want to keep losing, but I don't understand how I am staying the same with exercise and losing when I take a few days off.  And I went back to my plateau weight when I started moving again. :(

I eat about 900-1000 calories a day.  I upped it from 800 when I hit the plateau at your suggestion because of intense exercise.  i am not in the gym as much lately, I am trying to take advantage of the nicer weather (and due to vertigo, I am not allowed to drive right now), so I am burning as many calories walk/jogging as I did in the gym.

I am drinking 12 (8oz) cups of water a day or more on average.  between 90-100+ g of protein a day and carbs stay around 50g (ususally from dairy).

I am open to any suggestions, or do I just wait it out.  my scale has been within the same 5 pounds for the past 3 months.  I am at my 1 year surgiversary next week.  I guess I am just frustrated

Thanks :)

OK, so for women the answer to this question is very tricky. Let's start by saying the weight you lose today does not necessarily show up on the scale tomorrow. Your body processes things over time so while I do weigh myself every day generally speaking it takes 2-3 days to see the work I do today to show up on the scale. That being said as I get closer to my goal that scale move much more slowly. I have been in the same 5 or 6 lbs for about 3 months now.

Now back to my opening comment. There are a far more things that impact women's weight loss than men. I have said this a bunch of times before that hormonal balance is critical for weight loss in women. The problem with that is there are a LOT of things that impact women's hormones. Physical activity, sexual activity (or lack thereof), closeness to other women, your time of month, certain foods, and stress all can change your hormonal balance. Stress alone can upset the delicate balance. Stress produces a hormone called Cortisol that stops weight loss. I don't know or don't recall how old you are so this may or may not apply to you but if you are menopausal or pre-menopausal that can also impact how quickly you are losing weight.

Your macros and food/water intake look good to me so I don't think you have any issues there. So lets consider exercise. I had an ephiphany this morning regarding exercise and women's time of the month. I started to think about what happens to a women during that time and what the body is preparing to do. Basically about 3 days before through about a day or so after a women's menstruation, her body is preparing to become pregnant and nurture a child. This is a tremendous stress event. During this time I am willing to bet cortisol levels are particularly high. When you add strenuous exercise to that it compounds the problem. You are fighting against your body while it is actually trying to preserve body fat. Guess what? The body always wins. So I am going to start recommending to women that about 2 days before TOM until about a day after TOM you reduce your exercise to just walking. Your body wants to be moved but you don't want to cause stress events. So I think 60 mins of walking each day of that time is sufficient to burn some calories without increasing cortisol levels any higher than they already are. I am willing to bet you come out on the other side after a couple of days for your body to process things lighter than before.

So my guess is that your slow down/stall could be stress related perhaps?

How do you feel about strength training vs cardio in the first 6-12 months after surgery? I have picked up here and there from people who are from the camp that because we are creating such a deficit in calories that you will lose weight regardless as long as you stay on plan. It's for this reason I am considering focusing more on strength training my muscle groups rather than cardio. What are your thoughts?

I don't think it is a vs situation. I think you need to do both. This is not just a journey to a lower weight it is a journey to a healthier life. I think exercise is an important part of that. If you are just going to choose one then I would say go with strength training. More lean muscle mass burns more calories at rest. Cardio does not make you lose weight in strengthens your heart and lungs and blood flow in your body (which in turn carry nasty crap out of your body and carries around the good stuff to help you heal and grow).

You lose weight in the kitchen you get fit in the gym. 

You are right that we create a deficit and lose weight regardless but you will end up being a skinny fat person versus a skinny fit person. Also if you just rely on surgery to lose the weight your chances of regain are huge and almost a guarantee. If you adopt a healthy lifestyle that includes a healthy diet and exercise your chances for long-term success are far greater. Plus you may just find like I did that I really like to exercise.

"Skinny fat person" yessss that's my thought too. I guess my fear is losing the fat and mybody eating my muscles too.  I have a family member who had rny and she lost almost all of her muscle tone. I really don't want that for myself.

Thank you for taking time to answer our questions

The best way to avoid that is to eat lots of protein and weight training. If you sit around thinking about exercise instead of doing it, I promise you will have the same problem. Also remember that RNY is inherently a nutritionally deficient approach to weight loss. I mean the whole surgery bypasses the part of your intestines that absorbs nutrients. So its not a great comparison to look at the results of someone with RNY.

Hi - thanks for doing this. A few questions I've been percolating on. 

1. When choosing foods, is it better to pick lower fat or lower sugar? (I'm not diabetic now or before surgery.)

2. I am training for a triathlon. This means almost daily workouts - swim, spin class, or walking (can't run, I have severe arthritis in my right knee). I'm just over three months out fm surgery. What would you recommend for an easy pre-workout meal? I've tried protein bars and they make me feel ill. Turkey and a little cheese sits ok. I'm pretty over yogurt. Any thoughts?

3. Pyloric valve question - I understand your famous post and explanation. But is the biggest problem with drinking after eating that it could overfill the stomach? So is it really a problem if I eat just an ounce or two of something and then have some water less than 30 mins out? Also, is the drinking right before eating just an issue of filling up the stomach with water instead of protein? Just trying to understand the dynamics! 

Thanks,

jennifer